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Breast Augmentation Revision Options After Deflation

asked 1 year ago by tex13 in Las Vegas, NV
Latest answer by John P. Di Saia, MD
Question viewed 988 times
Tags: 700-749cc, capsular contracture, deflation

I had 550 cc moderate profile saline implants done in 2005 thru the armpit. Last week I had deflation in one breast. I've been to four consultations and learned I have capsulation and that the implants never made it into the pocket, I am a 36 D and would like to be a 36 DD. I am 5'8.5 and 150 lbs. At the consultations I've been told to go up to 700, 750, 775 and 800 cc's to achieve the size I want, I have also had different opinions on going high or moderate. What will give me the desired look?

21 answers to Breast Augmentation Revision Options After Deflation

Revision choices require examination and...

Hello, When considering revision, choices require good judgment. You need to have a good "face to face" discussion with your surgeon and a good exam to determine your best alternatives. Issues such as tissue elasticity and your chest diameter will be important in predicting your best implant geometry. Guessing over the internet is not going to be much help to you here. Best Regards John Di Saia MD see video

John P. Di Saia, MD
Orange Plastic Surgeon

Revisionary Breast Surgery

Clear communication with your plastic surgeon is important in achieving the desired goals of the patient. I like to communicate with patients with “goal” pictures. During surgery, I use temporary sizers to determine the size/profile that will give the patient the look she is looking for. Trying to predict the size of the implant preoperatively is not ideal. I think it is too much responsibility for the patient to choose the size of the implant. Ideally,... more

Tom J. Pousti, MD
San Diego Plastic Surgeon

www.poustiplasticsurgery.com

Breast implant revision

Your deflation is an opportunity in disguise because you can make some changes now. First, you need a new incision, not the armpit anymore. Second, capsules if thick need to be removed. You might need submuscular conversion if you are above the muscle (most armpits are below the muscle though). As for size, you should go for the "look" you want (not the cup size) by trying on sizers on your deflated side to see what implant will get closest to what you... more

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

www.randcosmeticsurgery.com

Trust your instincts

You have had several consultations which is a good start. Hopefully you have a good feeling about at least one of the surgeons. Hopefully you have a few good references for the one you like. Details of implant volume and style are secondary to the skill and judgement of your chosen surgeon. Likely a moderate plus profile would be best as you are looking for more impact and the volume will likely have to be at least 650cc or more to achieve a bigger cup size.

David J. Levens, MD
Coral Springs Plastic Surgeon

Breast Implant Revision and Going Bigger

First of all because the encapsulation, any revision will need an incision on the breast. It is difficult to give you an exact answer regarding implant size without actually examining you, but when you get into the 700cc+ sizes you are inviting some potential problems down the line. The implant needs to respect your breast dimensions, especially the breast width. Also because you will need a capsulectomy on the one side, this may leave your tissues thinner and make it more difficult to... more

Babak Dadvand, MD
Los Angeles Plastic Surgeon

Breast Implant deflation and Revision

Breast augmentation through the armpit is a great way to hide scars from breast augmentation. However, in the event of deflation or revision, usually, a different approach is needed. Addtionally, I would not recommend a large implant in the range of 700cc. Large implant will give you more problems in the future. The best way to solve your problem of capsular contracture is to see a board certified Plastic surgeon experienced in doing revision breast surgery. There are now many techniques... more

Stanley Okoro, MD
Atlanta Plastic Surgeon

How to treat a deflated implant and capsular contracture

I would not recommend using breast implants in the 700-800cc range. This will lead to premature sagging and atrophy (thinning) of the soft tissue of the breast. I would recommend doing a capsulectomy (likely on both sides) which will be best performed through either a periareolar or inframammary incision-not through the armpit. You may consider converting to silicone implants also which have a lower incidence of rupture. Although you are tall and have a frame that may... more

William Bruno, MD
Beverly Hills Plastic Surgeon

Breast augmentation revision

Implant deflation is a known complication of saline implants, and revision usually requires a different incision than the initial axillary one that was used to insert your implants - either an inframammary or a periareolar one. Determining the best implant size for you requires a complete physical examination, but very large implants (such as the 700+cc ones you are contemplating) are fraught with complications and long term negative effects on the tissues.

Olivia Hutchinson, MD
New York Plastic Surgeon

Large breast implants will be faster to sag

Based on your photos, your deflated right breast still has a respectable amount of breast tissue and is not ptotic. The left breast implant is positioned too high and the capsule is creating that unnatural bulge just below your collar bone. Revision can work with a large implant, but I would also consider use of a biologic implant such as Strattice or Alloderm to help counter the inevitable sagging with gravity in the future. The choice of moderate or high... more

Randy Wong, MD
Honolulu Plastic Surgeon

Which size should I go

Wthout actually examining you, there is really no way to determine the appropriate size that would look best for you. I would agree that 700 cc or greater implants are probably not the best thing in the long run since they will have a much greater chance of stretching out your tissue in the long run. If you do truly have encapsulation, you will most likely need to have the capsule addressed which is next to impossible through an axillary incision. I would get a... more

Gregory A. Buford, MD
Denver Plastic Surgeon

Malposition of Breast Implants

First and foremost I would not recommend get a 700 or 800 cc implant. Overt time you may regret that choice because of the potential harm it can do to your skin and breast tissue. Secondly, you will have to accept and incision in the breast crease. Stick with a moderate profile implant. Some internal work will have to be done on the left breast capsule. Schedule a couple of consults with board certified plastic surgeons. Dr. ES

Earl Stephenson Jr., MD, DDS
Atlanta Plastic Surgeon

Breast implant revision

Without a formal exam, I can not really comment on the appropriate breast implant size for you, but I will say that 700 or greater are extremely large implants.

Steven Wallach, MD
Manhattan Plastic Surgeon

Breast implant revision surgery requires special expertise

One of the disadvantages of the armpit approach is that revisions cannot usually be done through the same incision, so the first thing to accept is that a new incision will be needed. I am not sure what is meant by the implants "never made it into the pocket" since that is kind of a meaningless statement and doesn't help solve the problem. A theme you will note from the responses here is that nearly all of us caution that going larger means bigger problems in the long run. If... more

Richard Baxter, MD
Seattle Plastic Surgeon

Implant deflation and going larger

Your best result may require a biplanar approach to achieve sufficient release of the mammary parenchyma to allow satisfactory expansion of the breast tissue. However please read my artilce on large breast implants.

Otto Joseph Placik, MD
Chicago Plastic Surgeon

Revision breast augmentation

I would proceed with caution. Do you want this to be your last operation? Implants that are large are often associated with more complications as time passes. I am not sure I understand about the implants not making it in the pocket. I would consider a similar/slightly larger size via an inframammary approach.

David A. Lickstein, MD
Miami Plastic Surgeon

Breast Augmentation Revision

I am not sure whom you consulted, but several things suggest that they may not be board certified plastic surgeons. First, a 550 implant is quite large. Going to the sizes you mentioned risks many problems, both immediately and long term. I have as many requests for breast and implant reduction as for enlargement. One of the problems is capsular formation. Secondly, implants do not “make it into the pocket.” The surgeon creates the pocket and that is where the implant remains.... more

Robert T. Buchanan, MD
Highlands Plastic Surgeon

Breast Augmentation Revision Options, HELP!

My opinion is to try to obtain a 800 cc High Profile implant through an inframammary aproach. Thanks for the posted photo. From MIAMI Dr. Darryl J. Blinski

Darryl J. Blinski, MD
Miami Plastic Surgeon

Avoid revision breast augmentation with very large implants.

Hi. We would recommend an incision in the fold under your breasts, placing silicone implants over the muscle (because you have a little sagging), and not going over 400 cc's. Very large implants age very badly and stretch out your tissues. see video

George J. Beraka, MD
Manhattan Plastic Surgeon

Misshapen breast after breast implant and capsular contracture

I don't know what the surgeons you saw told you but breast implant surgery is not like buying clothing. You can't order a specific size. Although the surgeon can make some estimates as to final breast size he/she will always be off. This is due to the fact that breasts are made up of variable quantities of fat & breast gland. Although in general younger women have a greater percentage gland & older women have a greater percentage fat it is not possible for even the educated... more

Aaron Stone, MD
Los Angeles Plastic Surgeon

Bigger is not always better

That's a tough queurstion because there is no way for us to know what your "Desired look" is. I personally find a picture of your desired look helpful. Bigger is not always better and does include additional risk of complication. From the appearance of your body/chest size in combination with the size of the implants you are interested in, I would probably be leaning towards High profile implants. An experienced plastic surgeon should be the one to make this... more

Daniel P. Markmann, MD
Baltimore Plastic Surgeon

Breast revision options after implant deflation

Tex, The very best way to be able to tell you what will help you reach your goals is by an in person exam. You have some laxity of your left breast which may be improved upon by releasing the capsular contracture. I'm not sure what is meant by the implants never making it into the pocket but at least on the left side it is sitting higher and either needs to be lowered and/or the overlying breast tissue tightened with a lift of some type. There are most certainly options available for... more